Estrogen without anti-androgen: How quickly lower T?

[cookiemonster]

I am planning on doing an initial regimen of just Estrofem(estradiol) pills, and am wondering, for people who have gone with just estrogen, how quickly did your testosterone levels begin falling off and ultimately flatline?


OR maybe the regimen did not work for you, and the testosterone wasnt supressed as much as you'd like?  If thats true, how high is your T?

[Ms Grace]

Hi, welcome to the forum. It's unclear from your post but I hope you aren't planning on self medicating. An endocrinologist should be making those kind of decisions for you based on your current health, fitness and other factors.

[AnonyMs]

I was on relatively low estrogen only for some years, and my testosterone was below male and above female. Since starting anti-androgen and upping the estrogen my testosterone has dropped to low female. I was trying not to transition, but I feel so much better since the change that its hard to describe. Just in case you are planning on self medicating I'd suggest that this is a problem, since going to high level of HRT is risky and doing any less is not very satisfactory.

[Andreja Silvija]

I've read that estrogen without anti-androgens while having testes is harmful to your body. Your endocrinologist will prescribe you with anti-androgens so you need less of a dose of estrogen when you see them. 

[kelly_aus]

Your doctor is the person you should be asking this question..

I've read that estrogen without anti-androgens while having testes is harmful to your body.

Really? All the men in the world had better start taking some anti-estrogen meds then..

[JessicaH]

I've read that estrogen without anti-androgens while having testes is harmful to your body. 

I have never heard that much less seen anything published on it.  There are some good studies showing that estrogen is more than enough to suppress androgen levels to female levels for MOST MtF, given the right dosage.

Despite the name of the article, it's good information. http://www.medpagetoday.com/MeetingCoverage/ENDO/46497

[BreezyB]

I would imagine the amount of eostrogen you would need could become harmful, I thought it was always recommended to either start with anti androgen before or at the same time, with the added benefit being that one can take less oestrogen. T after all is a very powerful hormone!

[JessicaH]

It doesn't take that much. Comparable levels of natal females is within the range to do it for most of us. High levels of estrogen arent much of a risk if they are bio-identical.

[Andreja Silvija]

My psychologist gave me a link to the SoC book when I first visited her and I've read the whole thing a few times. It's where I got the idea from. YMMV I guess.

Androgen-reducing medications ("anti-androgens")
A combination of estrogen and "anti-androgens" is the most commonly studied regimen for
feminization. Androgen-reducing medications, from a variety of classes of drugs, have the effect
of reducing either endogenous testosterone levels or testosterone activity, and thus diminishing
masculine characteristics such as body hair. They minimize the dosage of estrogen needed to
suppress testosterone, thereby reducing the risks associated with high-dose exogenous estrogen
(Prior, Vigna, Watson, Diewold, & Robinow, 1986; Prior, Vigna, & Watson, 1989)

[JessicaH]

(Prior, Vigna, Watson, Diewold, & Robinow, 1986; Prior, Vigna, & Watson, 1989)

HRT studies and information have been changed so much in the last few years and most physicians don't do a good job at keeping up with the information.  Many physicians haven't even caught up with the meta-studies that tore apart the WHI (women's Health Initiative) studies due to serious flaws due to the mixing of data between different kinds of HRT.

Recent studies show the safety of bio-identical HRT (estrodiol/estrace/prometrium/micronized progesterone) as well showing the unnecessary risks that are posed by non-bioidenticals like conjugated estrogens, provera, etc.  Newer studies show that the bioidentical HRT is much safer and can be used at much higher levels that are comparable to natal women but many physicians are gun-shy and going by the safety and going by the safety protocols of the old drugs.

[Andreja Silvija]

I see. Thank you for the information Jessica. Truthfully, I was skeptical of quoting research from 1986. I see my endocrinologist for the 1st time later this month, so maybe he'll surprise me as well. Sorry for any confusion, just going off an old book.

[Jenna Marie]

(Yeah, don't self-medicate; my story also includes the fact that my 3-month test showed incipient liver damage that could have been REALLY serious if the doctor hadn't caught it. Turns out I'm so sensitive to E that a very low dose was still too much. I'm now on half the "starter amount" my endo prescribes.)

I started on a very low dose of E only with a T level of 190, and at my three-month checkup my T level was around 40, which is within the female range. I never ended up using anti-androgens at all because of this.

Estrogen-only HRT used to be the norm, but it generally did require doses so high as to be relatively dangerous. AAs are primarily used to allow for a lower, safer dose of estrogen. However, in some limited cases like mine, it's possible to get sufficient T reduction and estrogen for feminization on a dose considered safe even for cis women.

[Violet Bloom]

  I was started on AA alone first as per the experience of my health clinic.  They prefer to have the AA do the 'heavy lifting' of T reduction and it's other associated benefits while leaving E primarily for the feminization.  Everyone responds a little differently to dosage levels so HRT must be monitored and phased in gently.  Estrogen will probably be what kills you if either the dose is too high or your body reacts badly.  Play it safe and get regular blood tests per your doctor's instructions.  I would note that after one year I'm still only half way into the dosage ramp-up that my doctor expects I'll need to reach to be optimal for me.  Having patience is really important.  I don't remember my levels, but the doc says mine are comfortably into the normal female ranges now.

[Hideyoshi]

I was on relatively low estrogen only for some years, and my testosterone was below male and above female. Since starting anti-androgen and upping the estrogen my testosterone has dropped to low female. I was trying not to transition, but I feel so much better since the change that its hard to describe. Just in case you are planning on self medicating I'd suggest that this is a problem, since going to high level of HRT is risky and doing any less is not very satisfactory.

This is pretty much my experience. Not until I added spiro 8 months in and then upped E and added MPA months later was my T below male range.

[KayXo]

Estrogen-only HRT used to be the norm, but it generally did require doses so high as to be relatively dangerous.

When non bio-identical estrogens were given orally like Premarin and Ethinyl Estradiol. Today, bio-identical estrogen is available, usually prescribed and can be taken non-orally where harmful effects on health are much less as noted in several studies. Just thought I would add this as I consider this important.

Estrogen will probably be what kills you if either the dose is too high or your body reacts badly.

Moderation indeed but one must also realize that pregnant women experience VERY high levels during several months, higher in certain pregnant ciswomen that we'll ever even come close to and as far as I'm concerned, women are not dying left and right. Quite the contrary, they usually live longer than men. Estrogen is not a poison either, let's not exaggerate. It is produced sometimes in great quantities in a genetic woman and if one reads the pamphlets that come with it, say for instance with Estrace, effects from acute ingestion of large doses (contraceptives included) have not killed anyone and in fact do not appear to be associated with Serious side-effects.

HOWEVER, I'm also Not saying that estrogen is perfectly 100% safe but that one must also put things in context/in perspective and not over-exaggerate, I think. Not saying either that it is ok to take VERY large doses. You must obviously follow doctor's recommendations and stick to them at all times. Everyone is different, reacts differently and the doctor will tailor dose to the individual.

I would personally be more worried about AAs killing me than estrogen as the former is not native to the body if bio-identical estradiol is indeed taken.

added MPA

Just to let you know that there appears to be a safer form of progestogen available to us now where side-effects sometimes seen with MPA can be minimized or avoided. It is bio-identical progesterone and contrary to MPA, it might actually be an anti-depressant in SOME, has no androgenic effects and does not appear to either increase breast cancer risk, so far or induce changes in coagulation or artery walls that is a concern with MPA. Best to talk with your doctor, as always, share info with them and see what they say.

[judithlynn]

Hi Bree
When I restarted my transition. my Endo ran the blood tests and found that my T levels were very low for a male (a little over 5. Now after 20+ months on just low dose of Progynova  I am down to under 1 for T Levels, without any AA (Sorry cannot disclose exact amount) I have had moderate feminization. Luckily as I have no Adams Apple and small hands and feet, I can pass easily dressed as a woman (although now not so easy dressed as a man since with my B Cup breasts I have to wear baggy shirts or tops, as my erect nipples  are very obvious in tight T Shirts and it is quite obvious that I have rounded boobs. Also as I have added about 2.5" on my butt, I am getting to the male fail timezone.
Judith Lynn